Biomedical subjects

J A Falk

Publications and source records attributed to J A Falk.

At least 37 records · Page 2Linked to original sources

PubMed1985

An evaluation of factors associated with proliferative diabetic retinopathy.

Many individual factors have been related to development of proliferative diabetic retinopathy. To evaluate possible interactions among these, a constellation of variables were studied in 22 patients with long duration of insulin-dependent diabetes mellitus for greater than 25 years, with minimal background diabetic retinopathy, and compared to 27 patients with insulin-dependent diabetes mellitus for a variable duration, but with bilateral proliferative retinopathy. The patients were compatible in age at onset of diabetes (12 +/- 2 in proliferative retinopathy group vs 12 +/- 1 yr in the background retinopathy group). Following initial standard statistical analyses, data were further analysed using Logistic Regression Analysis. In the proliferative retinopathy group males were more prevalent (2.9:1), and patients were treated with larger insulin doses (0.86 +/- 0.07 vs 0.59 +/- 0.04 U/Kg B.W., p less than 0.001). Systemic hypertension and neuropathy were more prevalent (p less than 0.02 and less than 0.004 respectively), and diastolic blood pressure was higher (87 +/- 3 vs 75 +/- 2, p less than 0.01). In the same group diet was higher in carbohydrate and the ratio of polyunsaturated to saturated fats was lower (p less than 0.03, less than 0.05 respectively). HbA1 was higher (0.127 +/- 0.004 vs 0.110 +/- 0.004%, p less than 0.004), but the mean of all available plasma glucose values was not different. Impaired renal function expressed by higher BUN, serum creatinine, and urinary protein and lower creatinine clearance was observed. Nerve conduction parameters were more significantly impaired and plasma triglycerides were higher (1.74 +/- 0.2 vs 0.85 +/- 0.1 mmol/l, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1983

The effect of liver cytosol on hepatic regeneration and tumor growth.

This report further evaluates the concept that the interaction of factors that originate within the liver can contribute, regulate or even initiate the actual development of hepatic regeneration after liver cell necrosis or partial hepatectomy. The effect of liver cytosol (100,000 g supernatant), both from intact adult rat liver (NLC) and from adult rat liver remnants that had been regenerating for 24 hours after 70% partial hepatectomy (PH) in posthepatectomy liver regeneration in the rat was studied. The specificity of the growth-controlling properties in liver cytosol was determined using tumor cells. The intraperitoneal administration of NLC after PH resulted in approximately 70-80% inhibition of the peak 3H-DNA specific activity seen in controls at 18 and 24 hours post-PH, with a significant increase in DNA synthesis at 31-40 hours post-PH. The intraperitoneal administration of RLC after PH, augmented the hepatic regenerative response normally produced. Autoradiographic determination of hepatic nuclear labeling confirmed the inhibitory and stimulatory properties of NLC and RLC respectively. Syngeneic NLC or RLC at six and 24 days after subcutaneous tumor inoculation resulted in significant inhibition of tumor growth for both a methylcholanthrene-induced bladder carcinoma (FBCa) and an HTC-hepatoma. The retardation of FBCa growth could be enhanced by administering NLC or RLC every three or seven days. Syngeneic and xenogeneic liver cytosol resulted in dose-dependent inhibition of P815 mastocytoma cell proliferation in vitro. It is apparent from these studies that both stimulatory and inhibitory factors can be extracted from liver tissue that not only influence liver cell regeneration, but also affect tumor growth. Further isolation and characterization of these factors may lead to an understanding of more fundamental problems such as the control of normal and malignant cell growth.

Animals↗

PubMed1983

Nonspecific and selective stimulation of the immune system in the treatment of carcinoma in humans.

The experience of the Toronto General Hospital in the use of nonspecific stimulation of the immune system with bacille Calmette-Guérin (BCG) for the treatment of cancer of the gastrointestinal tract, malignant melanoma and breast cancer is described. The results are presented in terms of survival curves. The use of BCG administered intraperitoneally in a randomized study of patients with gastric, pancreatic and colorectal cancer proved of no benefit. On the other hand, when BCG was given orally in a randomized study of patients with resectable cancer of the colon and in nonrandomized consecutive studies of patients with malignant melanoma and stage IV carcinoma of the breast survival was increased. In a group of patients with advanced gastrointestinal cancer selective stimulation of the immune system with NED 137 produced a significant increase in survival when compared with the survival of historical controls (the patients given BCG intraperitoneally along with 5-fluorouracil for gastrointestinal cancer). The results of these studies suggest the need for a more rational approach in manipulating the immune response that would combine chemotherapy with selective stimulation of the immune system.

Aged↗

PubMed1983

Hyperthermochemotherapeutic in vivo isolated perfusion of the rat liver.

This report describes a system of in vivo isolated perfusion of the rat liver. The effects of perfusion with 5-fluorouracil (5-FU) (0.125-1.5 g/kg) on survival, liver function, and hepatic regeneration are studied. A dose of 0.125-0.25 g/kg of 5-FU produced acceptable toxicity with 0% and 25% mortality rate, but induced liver dysfunction indicated by abnormal biochemical values and severe inhibition of hepatic regeneration. Doses of 0.5 g/kg, 1.0 g/kg, and 1.5 g/kg produced a mortality of 60%, 100%, and 100%, respectively. Regional hyperthermia (37-43 degrees C) achieved by perfusion of the liver with heated saline produced an adverse effect on survival, liver function and hepatic regeneration, which are both temperature- and perfusion time-dependent. Hyperthermochemotherapy using in vivo isolated hepatic perfusion might be acceptable for the treatment of unresectable liver cancer, but should not be utilized as an adjuvant therapy prior to hepatic resection without the use of hepatic growth factors which could reverse the inhibitory effect of hepatic perfusion.

Alanine Transaminase↗

PubMed1983

Protection of thermochemotherapeutic-induced lethal acute hepatic necrosis in the rat by 16,16-dimethyl prostaglandin E2.

These studies further evaluate the hepatocytoprotective properties of 16,16-dimethyl prostaglandin E2 (dmPGE2) by assessing its effect on survival, liver function, and hepatic regeneration in a model of in vivo isolated perfusion of the rat liver with high concentrations of cytotoxic drugs and regional hyperthermia. Isolated perfusion with 1.0 g/kg of 5-FU or hyperthermia of 41 degrees C X 10 min resulted in 90-100% mortality in control rats, with extensive, patchy necrosis and infarction on histologic examination, and markedly elevated levels of SGOT and SGPT at 24 hr after perfusion. Pretreatment with dmPGE2 (10 micrograms/kg sc) at 30 min before, and at 6 and 24 hr after hepatic perfusion significantly improved survival to 80% (P less than 0.01) following 5-FU perfusion and to 40% (P less than 0.05) following hyperthermic perfusion. Animals were followed for at least 21 days after perfusion and demonstrated normal liver histology, dmPGE2-treated rats demonstrated significantly lower SGOT and SGPT levels at 24 hr after perfusion. dmPGE2 (2 micrograms/kg sc) given as above improved the length of time of survival but eventual mortality was not significantly improved. Oral administration (50 micrograms/kg po at 30 min before, 6 and 24 hr after perfusion) and posttreatment (10 micrograms/kg sc at 1, 6, and 24 hr after perfusion) had no significant effect on survival. Hepatic regenerative capacity following partial hepatectomy was severely suppressed following isolated hyperthermochemotherapeutic hepatic perfusion. Pretreatment with dmPGE2 (10 micrograms/kg sc) restored the DNA synthetic response in perfused rats to that seen in normal control rats after partial hepatectomy (P less than 0.05 and P less than 0.01). The results from these studies further confirm the role of dmPGE2 as a hepatocytoprotective agent and suggest potential clinical application in situations where there has been deliberate, therapeutic insult to the liver.

16,16-Dimethylprostaglandin E2↗

PubMed1983

Species cross-reactive Ia determinants: detection with a monoclonal antibody to human Ia of a murine Ia. 7 epitope.

A.TH anti-A.TL alloserum has previously been shown to react with monomorphic determinants of human Ia molecules. In an attempt to produce monoclonal antibodies detecting human-mouse cross-reacting epitopes, A.TH mice (Is) which lack I-E antigens were immunized with human Ia glycoproteins. Five hybridoma lines were established which recognize monomorphic human Ia determinants. Only one of the lines, 21w4, is reactive with murine cells and also with pig and sheep cells but not with rat cells. Binding studies to murine target cells show a strain distribution analogous to that of an Ia. 7-like specificity. The binding of 21w4 antibody to human and murine cells was compared to that of two other monoclonal antibodies directed to the murine Ia. 7-like specificity. Although all three antibodies had a similar pattern of reactivity with cells of different mouse strains, only 21w4 bound to the human cells tested. Competitive inhibition studies on murine cells have revealed that the epitopes were spatially related but not identical. Our results support the view that Ia. 7, the putative species cross-reacting specificity, might be composed of clusters of epitopes with variable degrees of conservation throughout evolution.

Animals↗

PubMed1983

HLA haplotype segregation in families of type 1 diabetics.

The hypothesis of linkage between HLA and a disease susceptibility (DS) locus (or loci) for type 1 diabetes was tested. HLA segregation was random among 57 non-diabetic sibs but not among 39 diabetic sibs, suggesting that susceptibility to type 1 diabetes may be due to an HLA-linked gene(s). The data did not fit a genetic model involving either a single recessive or dominant gene. The excess of HLA-identical diabetic sibs and the reduced number who were HLA-discordant compared to expected numbers indicated that factors from both paternal and maternal haplotypes were necessary for DS. In 1 of the 3 families with a diabetic parent and more than one diabetic sib, the diabetic sibs inherited different haplotypes from the affected parent, suggesting that either of these haplotypes conferred DS. HLAB 8, B 18 and B 40 were increased in frequency among 97 unrelated type 1 diabetics compared with 238 controls, especially among those with onset age less than 10 years. This early onset group may represent a subtype of type 1 diabetes.

Adolescent↗

PubMed1983

Comparison of in-vivo thermochemotherapy of isolated rat liver through portal vein and hepatic artery.

A model for the in-vivo perfusion of the isolated rat liver with either cytotoxic agents or hyperthermic saline, administered through either the hepatic artery or the portal vein, is described. Rats were able to survive following perfusion with a dose of up to 0.25 g/kg of 5-fluorouracil and 2.0 to 2.5 mg/kg of mitomycin-C by both routes. Regional hyperthermic perfusion of the liver produced temperature and time-dependent hepatotoxic effects. A marked elevation of serum glutamic oxaloacetic and glutamic pyruvic transaminase levels was noted 24 hours after perfusion, but was reversible. Aminopyrine N-demethylase activity in both normal intact and regenerating rat liver was not affected; however, the activity in normal intact liver was markedly suppressed with hyperthermic perfusion at 43 degrees C only. Incorporation of tritiated thymidine into hepatic deoxyribonucleic acid 24 hours after partial hepatectomy was severely inhibited by prior hepatic perfusion with either cytotoxic drugs or hyperthermic saline. This in-vivo isolated perfusion technique could be used to assess the effect of thermochemotherapy on tumour growth in the liver.

Aminopyrine N-Demethylase↗

PubMed1983

Reversal of lethal, chemotherapeutically induced acute hepatic necrosis in rats by regenerating liver cytosol.

In this report we further evaluate the role of regenerating liver cytosol (RLC) as a stimulator of hepatic regeneration by assessing its effect on survival, liver function, and hepatic regeneration in a model of in vivo isolated perfusion of the rat liver with high concentrations of cytotoxic drugs and regional hyperthermia. Isolated perfusion with 500 mg/kg of 5-fluorouracil (5-FU) and 2.5 mg/kg of mitomycin-C (Mit-C) resulted in 70% (n = 20) and 71% (n = 14) mortality, respectively, from 2 to 7 days after perfusion, with extensive, patchy necrosis and infarction seen on histologic examination and markedly elevated levels of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) at 6 and 24 hours after perfusion. The intraperitoneal administration of RLC (80 mg total protein/rat) at the time of hepatic perfusion resulted in 70% (5-FU, n = 20, P less than 0.05) and 80% (Mit-C, n = 20, P less than 0.01) survival at 21 days post perfusion. RLC-treated rats demonstrated significantly lower SGOT and SGPT levels at 6 and 24 hours after perfusion and normal liver histologic appearance by 14 days after perfusion in surviving rats. Hepatic regenerative capacity following partial hepatectomy was severely inhibited (P less than 0.001) following isolated hepatic perfusion with sublethal doses of 5-FU (125 mg/kg, 250 mg/kg), Mit-C (1.5 mg/kg) and hyperthermia (41 degrees C and 43 degrees C X 5 minutes). The administration of RLC at the time of partial hepatectomy restored the DNA synthetic response in perfused rats to that seen in normal control rats after partial hepatectomy (P less than 0.05). These results demonstrate that the liver is the source of a factor (s) (RLC) that significantly improves survival after lethal chemotherapeutic injury to the liver by stimulating endogenous hepatic regeneration. A potential clinical application for a stimulator of hepatic regeneration in situations of deliberate, therapeutic insult to the liver is suggested.

Acute Disease↗

PubMed1983

The effect of radiofrequency hyperthermia and chemotherapy upon human neoplasms when used with adjuvant metronidazole.

It appears that metronidazole causes an increase in tumor core temperature above that achieved with RFHT alone, by an as yet undetermined mechanism. Furthermore, radiofrequency hyperthermia, in combination with chemotherapy, can produce objective evidence of tumor repression in 30 to 50 per cent of the patients with metastatic cancer. These results justify proceeding to a randomized prospective trial of RFHT and chemotherapy in specific human neoplasms. Such a study is currently being undertaken at this center.

Adult↗

PubMed1982

Successful renal transplantation in patients with T-cell reactivity to donor.

A positive crossmatch due to T-cell reactivity against donor cells is considered a strong contraindication to renal transplantation because of the risk of graft loss from rejection. However, the significance of T-cell reactivity before but not at the time of transplantation is unknown. To determine whether transplantation can be successful under these circumstances, graft survival was observed in 15 highly sensitised patients whose T cells were reactive to donor sera before but not at the time of transplantation. All patients have been followed up for at least 1 year post transplant. Immunosuppression was by azathioprine, prednisone, and rabbit antithymocyte sera. 9 (60%) have functioning grafts and a mean serum creatinine of 1.6 mg/dl. Early non-function occurred in 12 patients. One graft was lost to early acute humoral rejection and two other to chronic rejection. 14 of the 15 had a fall in reactivity to a panel of normal lymphocytes before transplant. 4 of the 15 had donor-specific B-cell antibodies at the time of transplantation and 3 of these lost their grafts because of rejection.

Adult↗

PubMed1982

The incidence of type 1 (insulin-dependent) diabetes in Toronto.

An incidence of 9.0 out of 100,000 children under 19 years of age with Type 1 (insulin-dependent) diabetes was detected in Toronto during a 2 year prospective study. An increased number of cases occurred in the winter months of one of the years but not of the other during the study. The annual incidence was the same in each year. There were slightly more boys than girls but this was not significant. The diabetic children were significantly younger than their non-affected siblings. The incidence of Type 1 diabetes in Toronto is similar to other North American studies.

Adolescent↗

PubMed1982

Mechanisms of altered in vitro antibody response in the rat by a small synthetic polymer.

NED 137, a low molecular weight synthetic polymer, enhances the rat humoral immune response to cellular antigens in vivo. The effect of NED 137 on the in vitro antibody response to sheep erythrocytes was studied in normal and macrophage-depleted rat spleen cultures. The polymer stimulated the IgM antibody response of normal splenocytes, and its immunopotentiating activity was increased in macrophage-depleted spleen cell preparations. NED 137 enhanced both the primary and the secondary plaque-forming cell (PFC) response of rat splenocytes in a dose- and time-dependent manner. This stimulatory effect of the polymer was dependent on the presence of antigen and demonstrated antigen specificity. The PFC and mitogenic responses of both normal and macrophage-depleted rat splenocytes were dramatically inhibited in cultures prepared from animals pretreated with NED 137 before culture initiation. The antigen dependency, specificity and potentiation of a secondary response suggest that NED 137 acts through the triggering of the lymphoid system but not as a "conventional" B-cell polyclonal activator.

Adjuvants, Immunologic↗

PubMed1982

Sensitization to low dose 5-fluorouracil. Subsequent enhancement of its systemic antitumor effect in the rat.

This report describes a novel method of immunochemotherapy; the active immunization to the drug 5-fluorouracil (5-FU) with enhanced antitumor activity resulting from its subsequent systemic administration. Two metastasizing carcinomas in the Fischer strain (F344) rat have been used: a chemically induced bladder carcinoma (FBCa) and a spontaneous mammary adenocarcinoma (MACa). Both tumors grow rapidly and result in 100% mortality within 10 wk of implantation. Neither tumor is sensitive to systemic 5-FU alone. Intradermal sensitization to 5-FU before FBCa tumor implantation, followed by 5-FU administered systemically, resulted in significant tumor regression and improvement in survival with eradication of all tumor and cure in 20% of animals. A similar antitumor effect was observed with the MACa. A comparable drug effect was observed when methotrexate sensitization was given before FBCa implantation followed by systemic MTX. Specificity to the sensitizing drug was demonstrated by the lack of effect of sensitization with either 5-FU or MTX unless followed by systemic therapy with the requisite sensitizing agent. Sensitization to 5-FU has also been assessed after FBCa implantation followed by resection of the local tumor. Resection was performed after distant tumor metastases had occurred, and was followed by systemic 5-FU therapy. Whereas tumor resection alone failed to cure any animal, sensitization to 5-FU increased cure rate fourfold over animals receiving systemic 5-FU alone. Antibody to 5-FU in the sera of sensitized animals has been suggested by an immunoenzymatic staining technique and its specificity confirmed in a radioimmunoassay. It is postulated that a combination of the systemic agent and the antibody elicited to it by sensitization produces the significant antitumor effect observed. The antitumor effect observed with this new approach to immunochemotherapy warrants further experimental and clinical study.

Animals↗

PubMed1982

Lymphopenia and abnormal lymphocyte subsets in the "BB" rat: relationship to the diabetic syndrome.

The "BB" rat spontaneously develops insulitis followed by impaired glucose tolerance (IGT) and/or an insulin-dependent diabetic syndrome like that in man. All diabetic rats in this study showed marked lymphopenia in blood, lymph nodes, spleen, and thymus. Peripheral blood lymphopenia antedated glucoregulatory disturbances. All rats showing either insulitis with or without IGT or diabetes were lymphopenic. None with normal lymphocyte counts developed any abnormality. Diabetics showed marked decrease in the proportions of T+ lymphocytes in all tissues. The proportion of B (Ia+) lymphocytes was normal in blood, spleen and thymus, but increased in lymph nodes. However, in absolute terms both T and Ia+ lymphocytes were decreased. The subset decreased by the greatest proportion in all tissues was that which includes helper T lymphocytes. Thus: a) generalized lymphopenia most marked for T lymphocytes has been shown, b) helper T lymphocytes show proportionally the greatest reduction, c)thymic helper T deficit suggests a thymic origin of the lymphopenia, d) lymphopenia is a possible marker for susceptibility to the syndrome.

Animals↗

PubMed1982

The analysis with monoclonal antibodies of the heterogeneity of Ia glycoproteins on chronic lymphocytic leukemia cells.

The accessible Ia molecules on the surface of chronic lymphocytic leukemia (CLL) cells were quantitated in the cellular radioimmunoassay with saturating concentrations of monoclonal antibodies. Monoclonal antibody 21w4, like DA/2 antibody, recognizes monomorphic determinants of human Ia antigens. The amount of 21w4 or DA/2 bound to CLL cells derived from eight patients (varying from 2.6 to 13.9 x 10(5) molecules/cell) appears to be the maximum observed with the antibodies studied. Two other antibodies, 18d5 and 21r5, although also directed at nonpolymorphic Ia determinants, bind differentially to CLL cells, with the ratios of 21r5/21w4 and 18d5/21w4 varying from 0.08 to 0.90. Sequential immmunoprecipitation studies have established that the four epitopes 18d5, 21r5, 21w4, and DA/2 were present on the same molecules. All Ia molecules express 21w4 and DA/2 epitopes, whereas only certain subsets of Ia molecules carry accessible 21r5 or 18d5 epitopes. Competitive binding studies showed that the epitopes recognized by the four monoclonal antibodies were different. Monoclonal antibodies 21r5 and 21w4 did not inhibit each other's binding. Furthermore, binding of 21w4 to CLL cells potentiated the binding of 125I-21r5 IgG to the same cells, suggesting that binding of 21w4 antibody induces a conformational change in the molecule that renders 21r5 epitopes more accessible.

Adult↗

PubMed1982

A reevaluation of the putative association between the Fc gamma receptor and histocompatibility antigens on human mononuclear leukocytes.

The controversial question of an association between human Ia antigens and the FcR for immunoglobulin G has been examined. The experimental basis upon which such a relationship has been predicted was reevaluated. Human allosera with specificity for classical transplantation antigens, HLA-DR, and the related supertypic specificities MB and MT have been tested for their capacities to inhibit homologous EA rosette formation by PBM and B-CLL cells. Both immune and "nonimmune" sera inhibited rosette formation. Sera were normalized with respect to IgG concentration, and no significant quantitative differences in the observed inhibition were seen. Positive reactivity of the antisera with Ia, HLA-A, or HLA-B antigens did not influence EA binding to FcR. Furthermore, F(ab')2 of IgG from reactive sera did not inhibit rosette formation. These observations have been extended using murine reagents. A.TH anti-A.TL serum, which reacts with human Ia in binding and immunoprecipitation studies, and five monoclonal antibodies, which have been raised against human Ia and bind to monomorphic determinants, were tested for an effect on EA rosette formation. When these reagents were tested at concentrations at which they could be shown to bind to antigens on the target cell population, no inhibition of EA rosette formation by human PBM, MON or B-CLL cells could be demonstrated. The studies provide no evidence to suggest the existence of an association between Ia and the human FcR.

Animals↗

PubMed1982

Characterization of compounds shed from the surface of human leukemic myeloblasts in vitro.

Human leukemic myeloblasts shed glycoproteins from the cell surface during short-term in vitro culture. Shed surface glycoproteins yield a characteristic profile when studied by gel chromatography, isoelectric focusing, immune precipitation, and polyacrylamide gel electrophoresis. Isolation of immunologically active material yields a compound to approximately 75,000--80,000 daltons, with an isoelectric point of 7.6 to 7.9. Various morphological subtypes of acute myelogenous leukemia shed these compounds, but they are most easily obtained from the more differentiated M2 and M4 types as compared to the undifferentiated M1 type. The shed compounds appear to be quantitatively and qualitatively different from compounds shed by other leukemic cells or nonleukemic cells.

Cells, Cultured↗